Skip to main content
SpringerLink
Log in

Iris Implants

  • Chapter
  • First Online:
Current Advances in Ocular Surgery

Part of the book series: Current Practices in Ophthalmology ((CUPROP))

  • 238 Accesses

Abstract

This chapter will provide an overview of the management of large or total iris defects using prosthetic iris devices. It will cover the indications for artificial iris implantation, the types, and manufacturers of iris prostheses, how to select an appropriate device for a given situation, surgical technique, and the complications of artificial iris implantation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bouffard MA. The pupil. Continuum (Minneap Minn). 2019;25(5):1194–214.

    PubMed  Google Scholar 

  2. Burk SE, Da Mata AP, Snyder ME, Cionni RJ, Cohen JS, Osher RH. Prosthetic iris implantation for congenital, traumatic, or functional iris deficiencies. J Cataract Refract Surg. 2001;27(11):1732–40.

    Article  CAS  PubMed  Google Scholar 

  3. Srinivasan S, Ting DS, Snyder ME, Prasad S, Koch HR. Prosthetic iris devices. Can J Ophthalmol. 2014;49(1):6–17.

    Article  PubMed  Google Scholar 

  4. Sundmacher T, Reinhard T, Althaus C. Black diaphragm intraocular lens in congenital aniridia. Ger J Ophthalmol. 1994;3(4–5):197–201.

    CAS  PubMed  Google Scholar 

  5. Sundmacher R, Reinhard T, Althaus C. Black-diaphragm intraocular lens for correction of aniridia. Ophthalmic Surg. 1994;25(3):180–5.

    CAS  PubMed  Google Scholar 

  6. Miller AR, Olson MD, Miller KM. Functional and cosmetic outcomes of combined penetrating keratoplasty and iris reconstruction lens implantation in eyes with a history of trauma. J Cataract Refract Surg. 2007;33(5):808–14.

    Article  PubMed  Google Scholar 

  7. Wong VW, Lam PT, Lai TY, Lam DS. Black diaphragm aniridia intraocular lens for aniridia and albinism. Graefes Arch Clin Exp Ophthalmol. 2005;243(5):501–4.

    Article  PubMed  Google Scholar 

  8. Beltran-Agullo L, Alaghband P, Gurbaxani A, Lim KS. Phacoemulsification with therapeutic implantation of a prosthetic iris device following peripheral iridotomy visual complication. Eye (Lond). 2011;25(8):1096.

    Article  CAS  PubMed  Google Scholar 

  9. Thompson CG, Fawzy K, Bryce IG, Noble BA. Implantation of a black diaphragm intraocular lens for traumatic aniridia. J Cataract Refract Surg. 1999;25(6):808–13.

    Article  CAS  PubMed  Google Scholar 

  10. Petousis V, Krause L, Willerding G, Foerster MH, Bechrakis NE. Results and complications after implantation of a black iris-lens diaphragm in patients with traumatically induced aphakia and aniridia. Eur J Ophthalmol. 2011;21(6):754–9.

    Article  PubMed  Google Scholar 

  11. Omulecki W, Synder A. Pars plana vitrectomy and transscleral fixation of black diaphragm intraocular lens for the management of traumatic aniridia. Ophthalmic Surg Lasers. 2002;33(5):357–61.

    Article  PubMed  Google Scholar 

  12. Dong X, Yu B, Xie L. Black diaphragm intraocular lens implantation in aphakic eyes with traumatic aniridia and previous pars plana vitrectomy. J Cataract Refract Surg. 2003;29(11):2168–73.

    Article  PubMed  Google Scholar 

  13. Moghimi S, Riazi Esfahani M, Maghsoudipour M. Visual function after implantation of aniridia intraocular lens for traumatic aniridia in vitrectomized eye. Eur J Ophthalmol. 2007;17(4):660–5.

    Article  CAS  PubMed  Google Scholar 

  14. Choyce P. Intra-ocular lenses and implants. London: HK Lewis; 1964.

    Google Scholar 

  15. Srinivasan S, Yuen C, Watts M, Prasad S. Endocapsular iris reconstruction implants for acquired iris defects: a clinical study. Eye (Lond). 2007;21(8):1109–13.

    Article  CAS  PubMed  Google Scholar 

  16. Karatza EC, Burk SE, Snyder ME, Osher RH. Outcomes of prosthetic iris implantation in patients with albinism. J Cataract Refract Surg. 2007;33(10):1763–9.

    Article  PubMed  Google Scholar 

  17. Ghaffari R, Aldave AJ, Al-Hashimi S, Miller KM. Complications of cosmetic artificial iris implantation and post explantation outcomes. Am J Ophthalmol. 2021;226:156–64.

    Article  PubMed  Google Scholar 

  18. Hoguet A, Ritterband D, Koplin R, Wu E, Raviv T, Aljian J, Seedor J. Serious ocular complications of cosmetic iris implants in 14 eyes. J Cataract Refract Surg. 2012;38(3):387–93.

    Article  PubMed  Google Scholar 

  19. El Chehab H, Gatinel D, Baudouin C, Muraine M, Hoffart L, Rozot P, Mehanna C, Bonnet C, Nordmann JP, Santiago PY, Burillon C, Baillif S, Pisella PJ, Weber M, Robinet-Perrin A, Deidier D, Hay A, Villain M, Baïkoff G, Gauthier AS, Mathis T, Dot C. Complications of cosmetic iris implants: French series of 87 eyes. J Cataract Refract Surg. 2020;46(1):34–9.

    Article  PubMed  Google Scholar 

  20. Snyder ME, Miller KM, Price F Jr, Hardten DR, Fram N, Srinivasan S, Stulting RD. Preventing confusion between iris color-changing implants and therapeutic iris prostheses. J Cataract Refract Surg. 2020;46(5):804–5.

    Article  PubMed  Google Scholar 

  21. Chung MY, Miller KM, Weissman BA. Morcher iris reconstruction lens and rigid contact lens for traumatic aniridia. Eye Contact Lens. 2009;35(2):108–10.

    Article  PubMed  Google Scholar 

  22. Date RC, Olson MD, Shah M, Masket S, Miller KM. Outcomes of a modified capsular tension ring with a single black occluder paddle for eyes with congenital and acquired iris defects: report 2. J Cataract Refract Surg. 2015;41(9):1934–44.

    Article  PubMed  Google Scholar 

  23. Olson MD, Masket S, Miller KM. Interim results of a compassionate-use clinical trial of Morcher iris diaphragm implantation: report 1. J Cataract Refract Surg. 2008;34(10):1674–80.

    Article  PubMed  Google Scholar 

  24. Lin SR, Miller KM. Lessons learned from implantation of Morcher 50D and 96S artificial iris diaphragms. Case Rep Ophthalmol. 2017;8(3):527–34.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Miller KM, Nicoli CM, Olson MD, Shah M, Masket S. Outcomes of implantation of modified capsule tension rings with multiple black occluder paddles for eyes with congenital and acquired iris defects: report 3. J Cataract Refract Surg. 2016;42(6):870–8.

    Article  PubMed  Google Scholar 

  26. Miller KM, Kuo A, Olson MD, Masket S. Safety and efficacy of black iris diaphragm intraocular lens implantation in eyes with large iris defects: report 4. J Cataract Refract Surg. 2018;44(6):686–700.

    Article  PubMed  Google Scholar 

  27. Aslam SA, Wong SC, Ficker LA, MacLaren RE. Implantation of the black diaphragm intraocular lens in congenital and traumatic aniridia. Ophthalmology. 2008;115(10):1705–12.

    Article  PubMed  Google Scholar 

  28. Price MO, Price FW, Chang DF, Kelley K, Olson MD, Miller KM. Ophtec iris reconstruction lens United States clinical trial phase I. Ophthalmology. 2004;111(10):1847–52.

    Article  PubMed  Google Scholar 

  29. Wang H, Jung J, Lin SR, Olson MD, Miller KM. Safety and efficacy of colored iris reconstruction lens implantation. Am J Ophthalmol. 2020;216:174–85.

    Article  PubMed  Google Scholar 

  30. Mayer CS, Reznicek L, Hoffmann AE. Pupillary reconstruction and outcome after artificial iris implantation. Ophthalmology. 2016;123(5):1011–8.

    Article  PubMed  Google Scholar 

  31. Bonnet C, Miller KM. Safety and efficacy of custom foldable silicone artificial iris implantation: prospective compassionate-use case series. J Cataract Refract Surg. 2020;46(6):893–901.

    Article  PubMed  Google Scholar 

  32. Magnus J, Trau R, Mathysen DG, Tassignon MJ. Safety of an artificial iris in a phakic eye. J Cataract Refract Surg. 2012;38(6):1097–100.

    Article  PubMed  Google Scholar 

  33. Rana M, Savant V, Prydal JI. A new customized artificial iris diaphragm for treatment of traumatic aniridia. Cont Lens Anterior Eye. 2013;36(2):93–4.

    Article  CAS  PubMed  Google Scholar 

  34. Forlini C, Forlini M, Cavallini GM. Simultaneous correction of post-traumatic aphakia and aniridia with the use of artificial iris and IOL implantation. Graefes Arch Clin Exp Ophthalmol. 2013;251(10):2493–4.

    Article  PubMed  Google Scholar 

  35. Ayliffe W, Groth SL, Sponsel WE. Small-incision insertion of artificial iris prostheses. J Cataract Refract Surg. 2012;38(2):362–7.

    Article  PubMed  Google Scholar 

  36. CustomFlex artificial iris professional use information. Clinical Research Consultants, Inc.; 2018.

    Google Scholar 

  37. Ayres BD, Fant BS, Landis ZC, Miller KM, Stulting RD, Cionni RJ, Fram NR, Hamilton S, Hardten DR, Koch DD, Masket S, Price FW Jr, Rosenthal KJ, Snyder ME. Results of the United States FDA clinical trial of the CustomFlex artificial iris. Ophthalmology. 2022;129:614–25.

    Article  PubMed  Google Scholar 

  38. Yildirim TM, Khoramnia R, Masyk M, Son HS, Auffarth GU, Mayer CS. Aesthetics of iris reconstruction with a custom-made artificial iris prosthesis. PLoS One. 2020;15(8):e0237616.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Mayer C, Scharf D, Khoramnia R. Exchange of aniridia IOLs for customized iris IOL implants. Ophthalmologe. 2022;119:181–9.

    Article  CAS  PubMed  Google Scholar 

  40. Mayer C, Khoramnia R. Pupil reconstruction with an artificial iris. Ophthalmologe. 2022;119:3–12.

    Article  PubMed  Google Scholar 

  41. Mayer CS, Hoffmann AM, Prahs P, Reznicek L, Khoramnia R. Functional outcomes after combined iris and intraocular lens implantation in various iris and lens defects. BMC Ophthalmol. 2020;20(1):370.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Pozdeyeva NA, Pashtayev NP, Lukin VP, Batkov YN. Artificial iris-lens diaphragm in reconstructive surgery for aniridia and aphakia. J Cataract Refract Surg. 2005;31(9):1750–9.

    Article  PubMed  Google Scholar 

  43. Pozdeyeva N, Batkov Y. Iris trauma in a highly myopic woman with one functional eye October consultation #5. J Cataract Refract Surg. 2020;46(11):1575.

    Article  PubMed  Google Scholar 

  44. Christodoulou E, Batsos G, Parikakis E, Papadopoulos V, Karagiannis D, Koumoutsos PP, Tsilis A, Drazinos S. Combined post-traumatic total aniridia and glaucoma management. Case Rep Ophthalmol. 2021;12(1):204–7.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Snyder ME, Perez MA. Phakic implantation of flexible iris prosthesis. J Cataract Refract Surg. 2012;38(12):2208–9. author reply 2209

    Article  PubMed  Google Scholar 

  46. Mayer CS, Laubichler AE, Masyk M, Prahs P, Zapp D, Khoramnia R. Residual iris retraction syndrome after artificial iris implantation. Am J Ophthalmol. 2019;199:159–66.

    Article  PubMed  Google Scholar 

  47. Gooi P, Teichman JC, Ahmed II. Sutureless intrascleral fixation of a custom-tailored iris prosthesis with an intraocular lens. J Cataract Refract Surg. 2014;40(11):1759–63.

    Article  PubMed  Google Scholar 

  48. Beltrame G, Salvetat ML, Chizzolini M, Driussi GB, Busatto P, Di Giorgio G, Barosco F, Scuderi B. Implantation of a black diaphragm intraocular lens in ten cases of post-traumatic aniridia. Eur J Ophthalmol. 2003;13(1):62–8.

    Article  CAS  PubMed  Google Scholar 

  49. Mavrikakis I, Mavrikakis E, Syam PP, Bell J, Casey JH, Casswell AG, Brittain GP, Liu C. Surgical management of iris defects with prosthetic iris devices. Eye (Lond). 2005;19(2):205–9.

    Article  CAS  PubMed  Google Scholar 

  50. Osher RH, Burk SE. Cataract surgery combined with implantation of an artificial iris. J Cataract Refract Surg. 1999;25(11):1540–7.

    Article  CAS  PubMed  Google Scholar 

  51. Reinhard T, Engelhardt S, Sundmacher R. Black diaphragm aniridia intraocular lens for congenital aniridia: long-term follow-up. J Cataract Refract Surg. 2000;26(3):375–81.

    Article  CAS  PubMed  Google Scholar 

  52. Menezo JL, Martínez-Costa R, Cisneros A, Desco MC. Implantation of iris devices in congenital and traumatic aniridias: surgery solutions and complications. Eur J Ophthalmol. 2005;15(4):451–7.

    Article  CAS  PubMed  Google Scholar 

  53. Spitzer MS, Nessmann A, Wagner J, Yoeruek E, Bartz-Schmidt KU, Szurman P, Szurman GB. Customized humanoptics silicone iris prosthesis in eyes with posttraumatic iris loss: outcomes and complications. Acta Ophthalmol. 2016;94(3):301–6.

    Article  CAS  PubMed  Google Scholar 

  54. Mayer CS, Laubichler AE, Khoramnia R, Tandogan T, Prahs P, Zapp D, Reznicek L. Challenges and complication management in novel artificial iris implantation. J Ophthalmol. 2018:3262068.

    Google Scholar 

  55. Snyder ME. The latest on iris prostheses. Ophthalmol Manag. 2021;

    Google Scholar 

  56. Bahadur GG, Miller KM. Artificial iris exchange. J Cataract Refract Surg. 2020;46(12):1630–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stein Eye Institute, UCLA, Los Angeles, CA, USA

    Justin J. Park & Kevin M. Miller

Authors
  1. Justin J. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kevin M. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin M. Miller .

Editor information

Editors and Affiliations

  1. Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA

    Edmund Tsui

  2. Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA

    Simon S. M. Fung

  3. Department of Ophthalmology, Massachusetts Eye and Ear Harvard Medical School, Boston, MA, USA

    Rohan Bir Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Park, J.J., Miller, K.M. (2023). Iris Implants. In: Tsui, E., Fung, S.S.M., Singh, R.B. (eds) Current Advances in Ocular Surgery. Current Practices in Ophthalmology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1661-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-1661-0_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-1660-3

  • Online ISBN: 978-981-99-1661-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation